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There are many challenges women face to be able to give birth in health facilities in many parts ofIndonesia. This study explores the roles and observations of close-to-community maternal health providers and othercommunity members on potential barriers faced by women to deliver in health facilities in two districts within TheArchipelago. Methods: Employing an explorative qualitative approach, 110 semi-structured interviews and 7 focusgroup discussions were conducted in 8 villages in Southwest Sumba, in the East Nusa Tenggara province, and in 8 villagesin Cianjur, in the West Java province. The participants included village midwives, Posyandu volunteer (village healthvolunteers), traditional birth attendants (TBAs), mothers, men, village heads and district health officials. Results: Themain findings were mostly similar in the two study areas. However, there were some key differences. Preference forTBA care, traditional beliefs, a lack of responsiveness of health providers to local traditions, distance, cost of travel andindirect costs of accompanying family members were all barriers to patients attending health facilities for the birth oftheir child. TBAs were the preferred health providers in most cases due to their close proximity at the time of childbirthand their adherence to traditional practices during pregnancy and delivery. Conclusions: Improving collaborationsbetween midwives and TBAs, and responsiveness to traditional practices within health facilities and effective healthpromotion campaigns about the benefits of giving birth in health facilities may increase the use of health facilities inboth study areas. |
